00:02I’ve taken probably several thousand NP swabs anywhere from little babies to adults so I intuitively know where to go but you haven’t done many NP swabs or a little uncomfortable with it, I can show you quick easy technique that help ensure that you are going the right depth and getting an adequate sample.

00:24 What you do is take this disposable ruler supplied by Copan. You’re going to put it at the child’s earlobe and measure from there to the base of the nose, so on Mr. Roling here that is about 7 centimeters. And we will take that, open our swab package. You’re going to then take the swab. Lay it at the 7cm mark and mark it at 3 ½- so half the distance. In this case 3 ½. So we can see with our last patient, we went all the way up to the base where the widening is on the NP swab, In this case, we are going about a centimeter and a half less because of the smaller size of the head.

01:33 So in having the parent or guardian hold the child for this procedure, it is very important that the age of the child matters a lot. Babies are easier to hold. As they get bigger they start to wiggle more, as they get bigger than Roling, they start to kick. So you want to protect not just the patient but yourself when you’re getting the sample. (2:00)

02:00 So what I do is have the patient lie back against the person who’s helping. Just rest their head back like that. Roling you can open your eyes. And I have the parent or guardian hold their hands and put the other hand on their forehead. Then I cup their chin and now again you can see the depth of the nasal swab. You can push the nose up to help get the swab in. I usually don’t do that because what I do is I get the nasal swab in just a little and then turn towards from side to side. Okay, done.

02:55 Okay, you can see he got upset for about 2 seconds, As soon as we got our sample, you can see we got some nice mucus on that swab. Thank you Roling.

03:06 You’re gonna take the medium. You can either take this straight to your point-of-care test or again you can take your swab- I often mix it before I break it off. And again this red pink line is where you’re gonna snap it. Go right to the top, snaps off. And then you recap and you’re ready to send it off for testing.

03:56 This is little Maite. She is 10 months old and she’s here with fever of about 104 and having some flu-like symptoms. We’re going to get a quick NP swap on her so we can test her for flu during her visit today.

04:15 It helps with the younger babies that they get a little holding help. We have here mom to hold and we’ve got a second person to hold the head straight. So now we’re going to the same thing. Go in for the swab horizontally. Now we’re done.

04:40 Sometimes as in the case of this last little infant, when they’re fairly mobile, which the young toddler age is, you will get a little blood on the swab just from the friability of the nasal mucousa. If you see a little streaky blood like this, it’s not a problem. It’s not causing a major nosebleed. You just tell the parent that this is fairly common and happens very often with just the little movement of the child. No problem, there’s nothing to really take care of after. You won’t even see bleeding from the nose.

05:19 This is my friend Yedera. She is 6 years old. She’s here today because you have fever and coughing and you just don’t feel good, right? Okay. Well we’re gonna get a little swab from Yedera. We’re gonna test you for flu, okay? She’s gonna let us show you guys how to do this the best. Here we got a little measuring stick here, right Yedera? And we’re gonna put it here from the base of her nose back to her earlobes. You can see that she is right at 4in. So on our swab we’re gonna look at 2in to be the depth of insertion.

06:06 So we take our swab, take a quick sharpie marker. You can see that we have this. There am I looking right? Two inches? We’re gonna put our mark right there. So we have our little swab measure and she has already felt this and it’s a little fuzzy, isn’t it? It’s kinda’ just a little tickling feeling. So she knows she’s gonna hold real still for me. You can notice that I kinda’ tend to hold and just gently support the child like this on the chin so that they don’t move a lot when you’re doing the swab.